Cardio 1-2 Summary Flashcards
NYHA Classifiction
1- No Sxs w/ ordinary activity (ACEI/ARB)
2- Ordinary activity causes Sxs (Loop, Thiazides)
3- less than ordinary activities causes Sxs (Ald Antagonist, Entresto)
4- Sxs at rest (Digoxine, Dobutamine)
Define Pulsus Paradoxus
What conditions can cause it?
Inspiration causes SBP to dec >10mmHg
COST of COPD C. Pericarditis Obstructive airway SVCava obstruction Tamponade COPD
Criteria for OHOTN
What part of the criteria is most specific
Dec of HR by 30, SBP by 20, DBP by 10
HR- indicates low circulating volume
Define Osler’s Sign
Wide PP can be due to ?
Narrow PP can be due to ?
Calcified radial artery causes artificially high BP
AR
MR, MS, AS
Define Pulsus Alternans
Define Pulsus Parvus et Tardus
Changing PP amplitude due to LV dysfunction
Severe AS causing slow carotid upstroke
Define Pulsus Bisferiens
Define Spike and Dome pulse
Double wave from AS and AR
Double carotid pulse from HOCM
Normal boundaries and size for PMI
Normal duration of precordial palpitation?
5th ICS 10cm or less from midline, diameter 2-3cm
<1/2 of systole
What causes a loud S1
What causes a soft S1
Loud: THE Short PR
Tachycardia, High LA Press/CO, Early MS, Short PR
Soft: 1MC LH
1* Block, MR, Calcified MV, Late MS, High LV diastolic pressure,
What causes an S1 to vary in volume
What causes loud S2?
What causes soft S2?
VAC
Complete AV Block, V-tach, A-Fib
Soft: AS, PS
Loud: HTN, PHTN
What 4 issues can cause soft heart sounds?
What causes high pitched diastolic murmurs?
What causes low pitched diastolic murmurs?
POLE
Pulmonary effusion, Obese, Low CO, Emphysema
High: AR, PR
Low: MS, TS
What are the 6 parts of the JVP wave and what do they mean?
A wave: Atrial contraction
X descent: Atrial relaxation
C wave: TB bulge during RV systole, timed w/ carotid
X Prime: Heart base descent during ventricular systole
V wave: Passive atria filling against closed AV valve
Y descent: Early rapid atrial emptying
Lack of A-waves mean ?
Giant A-wave means ?
A-Fib, atrial stand still
Contacting atria against increased resistance
RVH, PS, TS, PHTN
Cannon A-waves mean ?
C-V waves mean ?
Contracting Atria against closed TV
AV dissociation, PVCs
Systolic venous pulsations
Regurgitating blood back into venous system in TR, makes a rapid y-wave
What does a sharp Y-descent mean?
Each small box on an EKG means ?
Each large box means ?
Constrictive pericarditis
Y > X phenomenon
- 04sec
- 2sec
EKG axis points ? hypertrophy and ? from infarcts
Normal axis range is -
Towards, Away
-30aVL - +30aVF
RVH criteria
LVH criteria
Must have RAD
No BBB
Dominant R in V1, dominant S in V5,6
Scott: Deepest S in V1,2 + deepest R in V5,6
RAE criteria
LAE criteria
P Pulmonale
R: P-wave >2.5mm in 2, 3, aVF
P Mitrale
L: P-wave >0.11s in 1, 2, aVL, V4-6 or,
Biphasic P-wave in V1
Where are Q waves normally present and where are they considered non-significant
What does the RCA supply blood to?
Normal in I, non-significant in III
2, 3, aVF Inf/Post LV RA/RV Post 1/3 of septum 70% of SA nodes 85% of PDAs AV node
What does the LAD supply?
What does the LCX supply?
V1-4
Ant 2/3 of septum
Bundle Branches
Bulk of LV/Ant surface
1, aVL, V5-6 25% of SA nodes Lat/Post LV LA 10% of PDA
What EKG changes are seen in Hyperkalemia
What EKG changes are seen in Hypokalemia
P FLEW
Peaked T, Flat P, Long PR, Elevated ST, Wide QRS
Flat UPS
Flat T, U wave, Prolonged QT, ST depression
What are the criteria for low voltage EKGs?
What are 3 drugs that can cause Prolonged QT and U waves?
Precordial leads <10mm
Limb leads <5mm
Quinidine, Phenothiazine, TCAs
How do PEs manifest on EKGs?
What is the purpose of using Holter Monitors
S1Q3T3
Pos aVR and V1
Detect arrhythmias
Relate Sxs to dysarrhythmia
Detect MIs
What does the Colour Flow on US assess for
TEEs are more sensitive and better for looking for ?
Valve regurgitation
Valve stenosis
Shunts
PEVD
Prosthetic heart valves, Emboli, Vegetations, IE, Dissection
Coronary angiography is the Gold Standard for ?, prognosis for ? and guiding therapy for ?
What information is provided by doing this procedure?
Detection/quantifying CAD
Post-MI
CABG vs PTCA vs medical therapy
Hemodynamics, Coronary anatomy, LVEF,